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Anterior abdominal wall defects
P M Lafferty1, A J Emmerson, P J Fleming
1Department of Child Health, Bristol Maternity Hospital.
Insights
Infants with abdominal wall defects like gastroschisis and exomphalos show high survival rates. Gastroschisis survival reached 95%, while exomphalos survival was 81% in a six-year review.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Congenital anomalies
Background:
- Abdominal wall defects, including gastroschisis and exomphalos, are significant congenital anomalies.
- These conditions require specialized neonatal surgical care.
Purpose of the Study:
- To review outcomes for infants with abdominal wall defects.
- To assess survival rates and factors influencing outcomes for gastroschisis and exomphalos.
Main Methods:
- Retrospective review of 48 infants with abdominal wall defects over six years.
- Analysis of survival rates and associated factors such as prenatal diagnosis and mode of delivery.
Main Results:
- Survival rates at one year were 95% for gastroschisis (21/22) and 81% for exomphalos (17/20).
- Most deaths were attributed to factors other than the abdominal defect itself.
- Prenatal diagnosis and parental counseling were reviewed for their impact on outcomes.
Conclusions:
- Neonatal surgical intervention for gastroschisis and exomphalos leads to high survival rates.
- Factors beyond the defect itself significantly influence infant outcomes.
Abstract:
A total of 48 infants with abdominal wall defects referred to the South West Regional Neonatal Surgical Centre over a period of six years were reviewed. There were 27 (56%) infants with gastroschisis and 21 (44%) infants with exomphalos. At the regional centre, four pregnancies with gastroschisis were terminated following a prenatal diagnosis, one child was stillborn, and one with exomphalos and trisomy 13 died soon after birth. Of the remaining 42 live births, the one year survival for babies born with a gastroschisis was 95% (21/22) and with an exomphalos was 81% (17/20). All deaths, except one, were due to factors other than the abdominal defect. The effect on outcome of prenatal diagnosis, parental counselling, in utero transfer, mode of delivery, and methods of surgical closure was reviewed.